In a game of Patchwork two players compete to see who can build the nicest, most complete and highest scoring patchwork quilt. Each player has a 9x9 game board on which to make their quilt from Tetris-like shaped pieces that are put into a trade row drafting-style and purchased with buttons, the in game currency. A third game board functions as a time-track and also determines what resources are available to a player on his or her turn. Both players have a spool game piece that they progress along the time track board in traditional roll and move board game fashion. Buttons are earned on this time track for purchasing quilt pieces as well as determining turn orders. Once both players have reached the center of the time track board, one button is subtracted for each blank space on their quilt board and the remaining buttons are tabulated to determine the player's respective scores.

While at first glance the game may appear to be a deceptively simple board game take on 2 player Tetris, there are many variables to consider while playing. Buttons must be spent to purchase quilt pieces, but are also used to determine victory points at the end of the game. Patches can be purchased to forward your own quilt, or with the purpose of slowing your opponent down. How a player handles movements on the time track effect how many moves his opponent will have on their next turn. While the game's basic rules are quite simple and easy to learn, there is a bit of resource management involved that can lead to some deceptively deep strategic planning.

The digital version of the game is well crafted and has been receiving positive reviews. Patchwork was created by Digidiced, a relatively new company in the digital board game domain who have received accolades for their excellent digital conversion of Le Havre: The Inland Port. The app version of Patchwork features an interactive tutorial, 3 levels of single player ai, global cross platform multiplayer, and the ability to customize the aesthetics of the app's menus and background with cosmetic-only enhancements available as in-app purchases. The game also has a "Playback" feature that allows players to analyze their past games as well as those of high-ranking players to learn some new tricks and strategies.